The economic and social consequences of alcohol abuse are immense. Job loss, family disruptions, and traffic fatalities are just some of the sequelae that contribute to alcohol abuse costing the United States over $165 billion per year. When individuals acknowledge the need for help, treatment planning is all too often a subjective process determined by what a patient believes and is willing to accept. For example, for some individuals a spiritually oriented 12-step treatment program with its attendant discussions of powerlessness and spirituality may be congruent with their personal histories and beliefs; for others, however, such a treatment experience might be discomfiting, potentially serving a negative function. Therefore, it seems reasonable to consider the spiritual orientations of the patient and treatment facility components of an interaction that influences outcome. The primary aim of this proposed two-year project is to examine whether admission differences in levels of spirituality predispose participants to favorable or unfavorable outcomes following admission to facilities that differ in the degree to which spirituality is emphasized. All participants will meet DSM-IV criteria for alcohol abuse or dependence. Since some persons are likely to be amenable to a treatment experience that emphasizes spiritual principles, while others are not, the proposed research will allow us to test the hypothesis that persons whose admission level of spirituality is congruent with the treatment program's orientation, and who as such are considered optimally placed (i.e., "matched") for treatment, evince better outcomes. Specifically, it is hypothesized that these patients will, relative to a group whose beliefs are not congruent with program philosophy, a) be less likely to terminate treatment prematurely, b) show greater gains in psychological functioning (i.e., abstinence efficacy), and c) be less likely to have renewed alcohol use at follow-up. Serial administration of measures of spirituality, learned helplessness, and abstinence efficacy will allow for an assessment of changes that accompany involvement in both treatment and the recovery process. Secondary analyses will examine the relationship of spirituality, helplessness and treatment outcome.